From Adolescence to Adulthood: Understanding Care Trajectories in an Early Detection and Intervention Centre in France

Author:

Marchini Simone1234ORCID,Laroche Marie‐Alix14,Nemorin Harmony14,Morin Valentine45,Tanguy Guillaume46,Lucarini Valeria147ORCID,Iftimovici Anton147ORCID,Chaumette Boris1478ORCID,Krebs Marie‐Odile147ORCID,Charre Mylene14

Affiliation:

1. GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne Pôle PEPIT, C'JAAD (Centre d'évaluation pour adolescents et jeunes adultes) Paris France

2. Service de Psychiatrie du Bébé, de l'Enfant, de l'Adolescent et du Jeune Adulte Hôpital Universitaire de Bruxelles (H.U.B.) Brussels Belgium

3. Faculté de Médecine Université Libre de Bruxelles (ULB) Brussels Belgium

4. Institut de psychiatrie ‐ Réseau transition, GDR3557 Paris France

5. CH La Chartreuse Centre Référent de Réhabilitation Psychosociale de Bourgogne (C2RB) Dijon France

6. Groupe Hospitalier Nord‐Essonne Site d'Orsay Unité de Soins Pour les Jeunes (UniSonJe) Bures‐sur‐Yvette France

7. Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM, U1266 Pathophysiology of Psychiatric Disorders: Development and Vulnerability Team Paris France

8. Department of Psychiatry McGill University Quebec Canada

Abstract

ABSTRACTBackgroundPsychiatric disorders often emerge during adolescence or young adulthood, leading to significant disability among youth. The transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) is critical for individuals experiencing emerging psychopathology, with delayed access to care negatively impacting long‐term outcomes. Accessing mental health services for adolescents and young adults is often complex and delayed due to challenges in service visibility, accessibility and appropriateness.MethodsThis study examines the care trajectories of individuals consecutively accessing the early detection and intervention (EDI) centre C'JAAD (Evaluation Centre for Young Adults and Adolescents) in Paris (France) over the year 2021. The main goal was to clarify the role of this EDI centre in the continuity of care and transition to AMHS. Data about their history of care, hospitalisations and referral sources were collected retrospectively.ResultsThe sample comprised 194 individuals, with 57.2% males and a median age of 20 years. Most patients (67.5%) were ≥18 years old upon arrival, with 31% in a situation of not being in education, employment, or training (NEET). Over one‐third (35.2%) had prior psychiatric hospitalisations. Patients were mainly referred to our EDI centre from other hospital departments (42.3%). Regarding care in CAMHS, 50.3% of the total sample had medical follow‐up during childhood, of whom 41.9% had discontinued care upon arrival at the EDI centre. The median onset age of care in CAMHS was 14, with a median duration of 12 months. Adult patients experienced an approximately 3‐year gap between the end of CAMHS care and assessment at the EDI centre.DiscussionThe sample's characteristics resemble those of other EDI centres, but concerns persist regarding referral timing and the NEET status of many youths. Lack of prior medical follow‐up and challenges in transitioning to AMHS underscore the need to enhance care continuity and address difficulties in accessing care during the transition to adulthood.

Funder

Koning Boudewijnstichting

Publisher

Wiley

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